This book covers all aspects of evoked potentials (EPs) utilized clinically in evaluating the functional integrity of somatosensory, auditory, motor, and visual pathways in the nervous system. It explores techniques needed to correctly perform EPs, and discusses these clinical neurophysiological tests that are performed in academic institutions and large community hospitals. Concise and comprehensive, this case-study rich text is divided into five chapters. Beginning with basic principles of evoked potential recording, the first chapter discusses signal enhancement and limitations of signal averaging. Chapter two then provides an overview of brainstem auditory EPs. Subsequent chapters then present visual EPs and somatosensory evoked potentials. Finally, the book concludes with clinical applications of transcranial magnetic stimulation, as well as a brief discussion of the techniques of transcranial electrical motor evoked potentials during intraoperative monitoring. Clinical Evoked Potentials: An Illustrated Manual functions as an essential reference for neurologists neurosurgeons, anesthesiologists, clinical neurophysiologists, and EP technologists, who are involved with the recording and interpretation of EPs primarily for diagnostic purposes.

Evoked potentials are potentials that are derived from the peripheral or central nervous system. They are time locked with an external stimulus and can be influenced by subjective intentions. Evoked potentials have become increasingly popular for clinical diagnosis over the last few years. Evoked potentials from the visual system are used by ophthalmologists in order to localize the abnormalities in the visual pathway. The otologists are mainly involved in brainstem auditory evoked potentials, while the pediatricians, neonatologists, neurologists and clinical neurophysiologists make use of multimodal stimulation. The psychiatrists and psychologists, generally, examine the slow potentials such as P300 and CNV. Anesthesiologists use short latency somatosensory and visual evoked potentials in order to monitor the effectiveness of the anesthesia. Pharmaco evoked potentials are very promising measures for the quan tification of the effectiveness of drug action on the cerebral cortex. Urologists are more and more involved in pudendal somatosensory evoked potentials and in the intensive care unit evoked potentials are used in order to monitor the functional state of the central nervous system of the patient. This overwhelming number of examinations and exam ina tors clearly demonstrates the need for guidelines and standardization of the methods used. The evoked potential metholody is restricted by the relative poor signal to noise ratio. In many diseases this signal to noise ratio decrease rapidly during the progression of the illness. Optimal technical equipment and methodology are therefore essential.

Evoked potentials have been used for decades to assess neurologic function in outpatient studies and are now routinely used in the operating room during surgery. Illustrated Manual of Clinical Evoked Potentials is a modern, practical guide to performing these studies and interpreting the results. The book is uniquely organized as a singular resource that provides the necessary background for understanding and conducting evoked potential studies. It functions as a multi-purpose text, atlas, and reading session, with numerous examples of studies and findings and discussion of key takeaways. Divided into five chapters, the book opens with an introduction to the basics of data acquisition and interpretation that lays the foundation for the modality-specific chapters that follow. The next group of chapters are in-depth reviews of visual, brainstem auditory, and somatosensory evoked potentials. Each of these chapters lays out the specifics of the modality and study protocol with examples to show how things should—and should not—be done. Sample studies with discussions about how to interpret them highlight a particular aspect of normalcy or pathology. Imaging correlates are provided to emphasize salient points and offer perspective. The final chapter is an overview of the use of evoked potentials during surgery with imaging and case discussions to introduce the reader to this very important application. Key Features Detailed review of methodology of evoked potential studies Many examples of actual patient studies with imaging correlates Interpretation of each evoked potential study presented in detail “Reading session”-like discussion of each example Special chapter on evoked potentials in the operating room

Authored by a leading clinical audiologist, the text is both complex and accessible, offering extensive review of test principles, protocols, and procedures for clinical application.

The vestibular labyrinth consists of ? ve compartments: the lateral, anterior, and posterior semicircular canals, the utricule, and the saccule. At the beginning of the twentieth century, Robert Bárány proposed the caloric test as a clinical test of the lateral semicircular canal. This test enabled clinicians to assess the individual lateral semicircular canal function easily by using the simple method of irrigating the external ear canal with cold or warm water and observing the induced nyst- mus. We believe that the caloric test was a breakthrough in the ? eld of vestibular research. However, as far as the other compartments were concerned, there was no simple clinical test equal to the caloric test for the lateral semicircular canal function. At the end of the twentieth century, the vestibular evoked myogenic potential (VEMP) test was proposed as a new method for assessing the individual saccule function. This test has some unique attributes. First, it uses sound stimulation, even though it is a test of the vestibular system. This appears to be a contradiction n- rophysiologically. As a result, in its early stages there were controversies conce- ing the origin of the responses. However, such controversies have been overcome by basic neurophysiological studies and clinical studies. Above all, sound sensit- ity of the saccular afferents shown in cats and guinea pigs with single-unit recording methods became the main supporting evidence. Nowadays, VEMP is one of the routine clinical tests for balance disorder.

This book reviews how we can record the human brain's response to sounds, and how we can use these recordings to assess hearing. These recordings are used in many different clinical situations--the identification of hearing impairment in newborn infants, the detection of tumors on the auditory nerve, the diagnosis of multiple sclerosis. As well they are used to investigate how the brain is able to hear--how we can attend to particular conversations at a cocktail party and ignore others, how we learn to understand the language we are exposed to, why we have difficulty hearing when we grow old. This book is written by a single author with wide experience in all aspects of these recordings. The content is complete in terms of the essentials. The style is clear; equations are absent and figures are multiple. The intent of the book is to make learning enjoyable and meaningful. Allusions are made to fields beyond the ear, and the clinical importance of the phenomena is always considered.